Notice of Privacy Practices

OHIO ENT
NOTICE OF PRIVACY PRACTICES
As required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION

Please review this notice carefully.

OUR COMMITMENT TO YOUR PRIVACY

Our practice is dedicated to maintaining the privacy of your protected health information (PHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your PHI. By federal and state law we must follow the terms of the notice of privacy practices that we have in effect at the time.
We realize that these laws are complicated, but we must provide you with the following important information:

How we may use and disclose your PHI
Your privacy rights in your PHI

Our obligations concerning the use and disclosure of your PHI

The terms of this notice apply to all records containing your PHI that are created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy retained by our practice. Any revision or amendment to this notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records that we may create or maintain in the future. Our practice will post a copy of our current notice in our offices in a visible location at all times, and you may request a copy of our most current Notice at any time.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

For Treatment Our practice may use your PHI to treat you. We may share your information with doctors, nurses, technicians, medical students, or other personnel who are involved with your care. We may share your information with health care providers outside of our practice for purposes related to your treatment. Finally, we may also disclose your PHI to others who assist in your care such as your spouse, children or parents.
For Payment Our practice may use and disclose your PHI in order to bill and collect payment for the services and items you may receive from us. We may also use and disclose your PHI to obtain payment from third parties that may be responsible for such costs, such as family members.
For Health Care Operations Our practice may use and disclose your PHI for health system operations. We may disclose your PHI to other health care providers and entities to assist in their health care operations. For examples, of the ways in which we may use and disclose your information for our operations, our practice may use your PHI to evaluate the quality of care you received from our staff, we may disclose information to doctors, nurses, technicians, student trainees, and other health system personnel for review and learning purposes. We remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who you are.
Appointment Reminders We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care within the system. If you do not wish to receive appointment reminders, or wish to be contacted at a certain telephone number, be sure to tell your health care provider.
Fundraising Activities We may use your health information to contact you in an effort to raise money for the Health System toward fulfilling its missions of patient care, teaching and research. We may provide demographic information (such as your name, address, phone number, gender, employer, birth date, spouses name and the dates you received treatment or services) to the Development Office or to a foundation related to the Health System.
Health-Related Benefits and Services We may use and disclose medical information to tell you about treatment options, health-related benefits, or services that may be of interest to you.
Release of Information to Family/Friends Our practice may release your PHI to a friend or family member that is involved in your care, or who assists in taking care of you. For example, a parent or guardian may ask that a babysitter take their child to the doctors office for treatment. In this example the babysitter may have access to this child’s PHI. In the event of an emergency, we may need to use or share information about you in order to inform your family or persons responsible for your care where you are, and your condition. In addition, we may disclose medical information abut you to an agency assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

SPECIAL SITUATIONS: Additional uses and disclosures for which authorization or opportunity to agree or object is not required by HIPAA

Research Our practice may use and disclose your PHI for research purposes in certain limited circumstances. All research projects are subject to a special approval process before we use or disclose medical information. We also may disclose medical information about you to people preparing to conduct a research project. They may be looking for patients with specific medical needs or for certain information. The medical information they review will be kept confidential. Often, you will need to give permission before we share your information with others for use in research. If your information is used, the researcher must keep your information safe and confidential.
As Required By Law We may release PHI if asked to do so by a federal, state or local law enforcement officer.
Serious Threat to Health or Safety Our practice may use and disclose PHI about you when necessary to prevent a serious threat to your health
Public Health Risks As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury, or disability; reporting medical device safety issues and adverse events to the federal Food and Drug Administration’s MedWatch program; and reporting disease or infection exposure
Workers' Compensation We may release PHI for workers’ compensation and similar programs.
Deceased Person Information We may release medical information to a coroner or medical examiner, or a funeral director as necessary to carry out their duties.
Specialized Government Functions We may release PHI about you to authorized federal officials for national security and intelligence, military, or veterans activities required by law

USES OF MEDICAL INFORMATION THAT REQUIRE AUTHORIZATION

In all other situations (situations that are not treatment, payment, health systems operations or special situations, as we told you about above), we may only share information with your specific written authorization. You may revoke that authorization, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent that we already have used or disclosed your information.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU

Although the physical form of your medical information or designated record set is our business record and is the property of the health system, the information contained in those records is your information, and you have certain rights regarding that information. You have the following rights regarding medial information we maintain about you:

Inspection and Copies you have the right to inspect and obtain a copy of the PHI that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes, information compiled for use in or created in anticipation of a civil, criminal or administrative action or proceeding, or certain lab test results subject to the Clinical Laboratories Improvement Act of 1988. You must submit your request in writing to the office manager of the office where you received your care in order to inspect and/or obtain a copy of your PHI. If you request a copy of the information, we may charge you a fee for the costs of copying, mailing, or other supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. The health care provider shall provide the record to a practitioner designated by you to help you with your review of the information.
Requesting Restrictions You have the right to request a restriction in our use of disclosure of your PHI for treatment, payment or health care operations,. Additionally, you have the right to request that we restrict our disclosure of your PHI to only certain individuals involved in your care of the payment for your care such as family members and friends. We are not required to agree to your request; however, if we do agree, we will comply with your request unless the information is needed to provide you emergency treatment or required by law. In order to request a restriction in our use or disclosure of your PHI, you must make your request in writing to our Complaint Coordinator; 1810 Mackenzie Dr.; Columbus, Ohio 43220. Your request must describe in a clear and concise fashion:
1. The information you wish restricted
2. Whether you are requesting to limit our practice’s use, disclosure or both
3. To whom you want the limits to apply
Right To Amend If you feel that the medical information we have about you is incorrect or incomplete, you may request an amendment for as long a the information is kept by or for our practice. We may deny your request if you ask us to amend information that we believe to be accurate and complete or is not part of the information which you would be permitted to inspect and copy. Please submit your request to the HIPAA Complaint Coordinator at 1810 Mackenzie Dr. Columbus, Ohio 43220
Right To An Accounting of Disclosure All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your PHI for non-treatment, non-payment or non-operations purposes. Use of your PHI as part of the routine patient care in our practice is not required to be documented. In order to obtain an accounting of disclosures, you must submit your request in writing. Tell us the calendar dates you want to see. The time period cannot include more than six years of information, and cannot begin prior to April 14, 2003.
Right To a Paper Copy of This Notice You are entitled to receive a paper copy of our notice of Privacy Practices. You may ask us to give you a copy of this notice at any time.
Right To File A Complaint If you believe your privacy rights have been violated, you may file a complaint with our practice to HIPAA Complaint Coordinator; 1810 Mackenzie Dr.; Columbus, Ohio 43220 or with the Office of Civil Rights, Washington, DC. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.

OHIO ENT